Derrick Silove1,2, Mohammed Mohsin3,4, Alvin Kuowei Tay3,4, Zachary Steel5, Natalino Tam6, Elisa Savio6, Zelia Maria Da Costa6, Susan Rees3,4. 1. Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, Australia. d.silove@unsw.edu.au. 2. Academic Mental Health Unit, Level 2 Mental Health Centre, The Liverpool Hospital, Sydney, Australia. d.silove@unsw.edu.au. 3. Psychiatry Research and Teaching Unit, University of New South Wales, Sydney, Australia. 4. Academic Mental Health Unit, Level 2 Mental Health Centre, The Liverpool Hospital, Sydney, Australia. 5. School of Psychiatry, St Johns of God, Richmond Hospital, The Black Dog Institute, University of New South Wales, St. John of God, Australia. 6. Alola Foundation, Dili, Timor-Leste.
Abstract
PURPOSE: Cumulative evidence suggests that explosive anger may be a common reaction among survivors of mass conflict. However, little is known about the course of explosive anger in the years following mass conflict, or the psychosocial factors that influence the trajectory of that reaction pattern. We examined these issues in a 6-year longitudinal study (2004-2010) conducted among adult residents of a rural and an urban village in Timor-Leste (n = 1022). METHODS: We derived a brief, context-specific index of explosive anger using qualitative methods. Widely used measures of post-traumatic stress disorder (PTSD) and severe psychological distress were calibrated to the Timor context. We developed an index of the cumulative sense of injustice related to consecutive historical periods associated with conflict in Timor-Leste. We applied partial structural equation modeling (SEM) to examine pathways from baseline explosive anger, socio-demographic factors, recurrent trauma, mental health indices (PTSD, severe psychological distress) and the sense of injustice, to explosive anger. RESULTS: Half of the sample with explosive anger at baseline continued to report that reaction pattern after 6 years; and a third of those who did not report explosive anger at baseline developed the response by follow-up. A symmetrical pattern of younger age, female gender and the trauma count for the preceding historical period predicted explosive anger at each assessment point. The sense of injustice was related to explosive anger at follow-up. Explosive anger was associated with impairment in functioning and conflict with the intimate partner and wider family. CONCLUSIONS: Sampling constraints caution against generalizing our findings to other populations. Nevertheless, our data suggest that explosive anger may persist for a prolonged period of time following mass conflict and that the response pattern is initiated and maintained by recurrent trauma exposure associated with a sense of injustice. Averting recurrence of mass violence and addressing persisting feelings of injustice may assist in reducing anger in conflict-affected societies. Whether explosive anger at the individual level increases risk of collective violence under conditions of social and political instability requires further inquiry.
PURPOSE: Cumulative evidence suggests that explosive anger may be a common reaction among survivors of mass conflict. However, little is known about the course of explosive anger in the years following mass conflict, or the psychosocial factors that influence the trajectory of that reaction pattern. We examined these issues in a 6-year longitudinal study (2004-2010) conducted among adult residents of a rural and an urban village in Timor-Leste (n = 1022). METHODS: We derived a brief, context-specific index of explosive anger using qualitative methods. Widely used measures of post-traumatic stress disorder (PTSD) and severe psychological distress were calibrated to the Timor context. We developed an index of the cumulative sense of injustice related to consecutive historical periods associated with conflict in Timor-Leste. We applied partial structural equation modeling (SEM) to examine pathways from baseline explosive anger, socio-demographic factors, recurrent trauma, mental health indices (PTSD, severe psychological distress) and the sense of injustice, to explosive anger. RESULTS: Half of the sample with explosive anger at baseline continued to report that reaction pattern after 6 years; and a third of those who did not report explosive anger at baseline developed the response by follow-up. A symmetrical pattern of younger age, female gender and the trauma count for the preceding historical period predicted explosive anger at each assessment point. The sense of injustice was related to explosive anger at follow-up. Explosive anger was associated with impairment in functioning and conflict with the intimate partner and wider family. CONCLUSIONS: Sampling constraints caution against generalizing our findings to other populations. Nevertheless, our data suggest that explosive anger may persist for a prolonged period of time following mass conflict and that the response pattern is initiated and maintained by recurrent trauma exposure associated with a sense of injustice. Averting recurrence of mass violence and addressing persisting feelings of injustice may assist in reducing anger in conflict-affected societies. Whether explosive anger at the individual level increases risk of collective violence under conditions of social and political instability requires further inquiry.
Authors: Derrick Silove; Vijaya Manicavasagar; Richard Mollica; Meng Thai; Dorani Khiek; James Lavelle; Svang Tor Journal: J Nerv Ment Dis Date: 2007-02 Impact factor: 2.254
Authors: F L Brown; K Carswell; J Augustinavicius; A Adaku; M R Leku; R G White; P Ventevogel; C S Kogan; C García-Moreno; R A Bryant; R J Musci; M van Ommeren; W A Tol Journal: Glob Ment Health (Camb) Date: 2018-08-13